CB: How can women get in touch with their feelings about the hospital beforehand ?

HB: By all means, take a tour of the hospital. Talk with friends who've had babies there—and with friends who've had babies at home. I always encourage pregnant women to take the tour. The results are sometimes very striking—people who were definitely going to give birth at home may realize they'd rather have it at the hospital, or, just as commonly, the exact opposite will happen, and a couple who's planned a hospital birth will decide to have it at home.

CB: What should a woman ask herself when she visits the hospital and takes the tour of the labor and delivery rooms?

HB: They should ask, "How do I feel about technology?" "How do I feel about being handled by competent strangers?" "How do I feel about mechanical things?" Sometimes the number of electric and electronic gadgets a woman has in her home will reflect her feelings about technology.

MW: Sometimes reading the right books helps people explore their feelings, too. It can make you aware that there are really more possibilities than you might have thought.

CB: Why do you think there's been such heated controversy about home births in some places, while in other areas it's just seemed to slowly evolve and be well accepted ?

HB: I think that some health workers are scared. They're afraid that they'll lose financially, or that obstetricians might be phased out completely. And some non-health workers have just turned their backs on health workers altogether and gone off to deliver their own babies at home.

My feeling is that both extremes are off the mark. A certain degree of technical training and experience is clearly helpful in figuring out the small percentage of women who are at higher than normal risk. At the same time, families need to be able to arrange a birthing experience that meets their needs, not the health workers' needs. Birthing should be a collaborative effort, with input from both the family and the health workers involved. Neither party can manage as well without the other.

CB: What are the qualities to look for in the person you want to attend your birth?

HB: How you feel about a person is very important. When it came to choosing someone for my own birth, I passed up a number of doctors I knew and picked one I hardly knew at all because I had very good feelings about him.

MW: I would also want to check on their competence. Ask somebody they've helped to deliver, or ask other health workers who've worked with them. I'd ask a health worker friend whom he or she would go to. It's also important to consider who has hospital privileges where.

HB: Another important thing is whether the person really listens to you. Birthing works best when both attendants and parents are really listening to each other and learning from each other.

Also, a doctor who delivers fifty or sixty times a month by himself is not going to have time to give you much personal attention. He'll be forced to scoot you in and scoot you out. So be sure and ask how heavy a case load the person carries.

Finally, I'd choose a person who's not locked into either a home birth or a hospital birth.

MW: Yes, the parents' feelings may change at any point and they should be supported. The option to have a baby at home or to go to the hospital should be kept open as long as possible.

HB: To realize that you can change your mind, shift plans, and still have a positive birth experience is very important. Maybe you have been planning on a hospital birth, and once you get there, realize that it would have been better at home. Or maybe your game plan has been home birth and you feel yourself wishing you were in the hospital. It's okay to say, " Hey, wait a minute. This doesn't feel right." And change the game plan so that it does feel right.

Tom Ferguson, M.D. (1943-2006), was a pioneering physician, author, and researcher who virtually led the movement to advocate informed self-care as the starting point for good health. Dr. Ferguson studied and wrote......more

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